Kodi mukudziwa za vuto lotchedwa Endoleak lomwe limachitika munthu akalandira chithandizo cha aneurysm?

Kodi mudamvapo za Aneurysm, vuto lomwe khoma la mtsempha wamagazi kapena mtsempha waukulu wamagazi m'thupi limafooka ndikutupa ngati baluni? Mwina mudadwalapo, ndipo madokotala adachiza poika chubu chaching'ono chotchedwa Stent Graft, chomwe ndi njira yotchedwa Endovascular, kutanthauza popanda kudula kwambiri. Taganizirani ngati kutuluka kwa madzi mu chitoliro chakale chamadzi. Choncho madokotala amaika chubu china mkati mwa kutuluka kwa madzi kuti chikhale cholimba. Komabe, nthawi zina pambuyo pa chithandizo chimenecho, magazi pang'ono amayamba kutuluka mu Stent Graft, kupita mu thumba lomwe Aneurysm inali. Ndicho chimene timatcha Endoleak mu mankhwala. Lero, tikambirana mwatsatanetsatane za izi kwenikweni, chifukwa chake zimachitika, kodi ndizoopsa, momwe tingazizindikire, komanso mankhwala ake.

Kodi Endoleak kwenikweni ndi chiyani?

Mwachidule, Endoleak amatanthauza kuti pambuyo poti Aneurysm yachiritsidwa ndi kutsekedwa, magazi amayamba kuyendanso mkati mwa thumba lakale la Aneurysm. Tsopano, onani, nthawi zambiri Aneurysm ikachiritsidwa, magazi anu amangoyenda kudzera mu chubu cha Stent Graft chomwe changoyikidwa kumene. Stent Graft iyi ili ngati chothandizira khoma la mitsempha yamagazi yofooka. Chifukwa chake, magazi samayenda kupita ku gawo lowonongeka, lotupa la mitsempha yamagazi, ndiko kuti, Aneurysm Sac. Kenako Aneurysm imasiya kukula ndikuphulika. Ziyenera kukhala bwino ngati palibe kutuluka magazi.

Komabe, ngati pazifukwa zina magazi akutuluka kunja kwa Stent Graft ndi kulowa mu Aneurysm Sac, chomwe chimatchedwa Endoleak. Pali zifukwa zosiyanasiyana zomwe Endoleak iyi imachitikira. Zina mwa izo zimachitika chifukwa cha mavuto a Graft yokha, ndipo zina mwa izo zitha kukhala chifukwa cha mitsempha ina yaying'ono yamagazi yoyambira ku Aneurysm Sac. Zili ngati madzi akutuluka kuchokera kumalo ena denga litatsegulidwa.

Ngati Endoleak ichitika mkati mwa masiku 30 kuchokera pamene chithandizo cha Endovascular ichi chikuchitika, timachitcha endoleaks oyambirira . Amene amakula pambuyo pa masiku 30 amatchedwa secondary endoleaks kapena late endoleaks .

Kodi Endoleak ndi yofala bwanji?

Tsopano mwina mukudabwa ngati 'Endoleak' iyi ndi chinthu chomwe chimachitikira aliyense kapena sichimachitika kawirikawiri. Ndipotu, vuto la 'Endoleak' ili limatha kuchitika mwa munthu m'modzi mwa anayi omwe amalandira 'Endovascular Aneurysm Repair' (mwachidule timalitcha 'EVAR' - iyi ndi njira yochizira makamaka 'Aneurysm' m'khoma la m'mimba) kapena 'Thracic Endovascular Aneurysm Repair' ('TEVAR') ya 'Aneurysm' pachifuwa . Chifukwa chake, sizosamveka. Ndicho chifukwa chake ndikofunikira kudziwa izi.

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Kodi Endoleak ndi yoopsa?

Izi zingakuopseni pang'ono. "O, ndikuopa kuti idzatulukanso magazi, sichoncho?" Mungaganize. Koma si ma endoleak onse omwe ndi owopsa . Ma endoleak ena savulaza ndipo amachira okha. Monga momwe bala laling'ono limachira lokha. Zikatero, dokotala wanu angasankhe kungoyang'anira vuto lanu. Izi zikutanthauza kupitiriza kuchita mayeso ndikuwona zomwe zikuchitika.

Komabe, mitundu ina ya Endoleak ndi yoopsa kwambiri. Pofuna kupewa kuthekera kwa Aneurysm imeneyo kukulanso ndikuphulika, iyenera kuchiritsidwa mwachangu. Chifukwa ngati Aneurysm yaphulika, ikhoza kukhala yoopsa pa moyo. Chifukwa chake, kaya izi ndi zoopsa kapena ayi zimadalira mtundu wa Endoleak ndi komwe ili. Madokotala amapanga zisankho kutengera zinthu zonsezi.

Kodi pali mitundu iti ya Endoleak?

Pakadali pano pali mitundu isanu ya Endoleak yomwe yadziwika. Mtundu uliwonse uli ndi chifukwa chosiyana. Monga momwe matenda aliwonse alili ndi chifukwa chake. Ndi chitukuko cha ukadaulo watsopano wa Stent Graft, mitundu ina ya Endoleak tsopano yachepa pang'ono, zomwe ndi zabwino.

Mwa izi , Mtundu wachiwiri wa Endoleak ndiye wofala kwambiri . Komabe , Mtundu wa 1 ndi Mtundu wa 3 wa endoleak ndi woopsa pang'ono , chifukwa umawonjezera chiopsezo cha kuphulika kwa Aneurysm (rupturing). Tiyeni tiwone bwino mitundu iyi.

Mtundu 1 wa Endoleak

Izi zimachitika pamene stent graft sinalumikizidwe bwino pakhoma la mtsempha wamagazi, zomwe zikutanthauza kuti sinatsekedwe bwino. Tangoganizirani, ngati pali mpata wawung'ono pakati pa chivundikiro ndi khoma, madzi adzatuluka kuchokera pamenepo, ndipo magazi adzatuluka kuchokera kumapeto apamwamba (pafupi) kapena kumapeto otsika (kutali) kwa stent graft ndikulowa mu thumba la aneurysm. Mtundu 1 endoleak ndi vuto lalikulu, kotero nthawi zambiri limafuna chithandizo chachangu. Izi zitha kuswa aneurysm kuposa mitundu ina. Ngati madokotala awona izi, adzachitapo kanthu mwachangu.

Mtundu wachiwiri wa Endoleak

Uwu ndi mtundu wofala kwambiri wa endoleak . Umapezeka kwambiri pambuyo pa EVAR kuposa TEVAR pa aneurysms ya m'mimba. Kutuluka kumeneku kumachitika magazi akatuluka kuchokera ku aorta yanu kapena mtsempha wamagazi womwe uli ndi stent kulowa mu aneurysm sac kudzera m'mitsempha yaying'ono yamagazi (mitsempha ya nthambi kapena mitsempha yolumikizana). Tangoganizani kuti aorta yanu ili ndi nthambi zazing'ono (nthambi). Tsopano, ngakhale titayika stent graft yatsopano kuti titseke dzenje mu aorta, magazi ena amatha kutuluka kuchokera ku nthambi zimenezo. Umu ndi momwe endoleak ya Mtundu Wachiwiri ilili.

Nthawi zambiri, matenda a Endoleaks amtundu wa 2 amapezeka mkati mwa masiku 30 kuchokera pamene mwalandira chithandizo cha Endovascular. Komabe, nthawi zina amatha kuchitika pambuyo pake, otchedwa "late endoleaks." Pafupifupi 40% ya matenda a Endoleaks amtundu wa 2 amapezeka patatha masiku 30. Pafupifupi 8% amapezeka patatha chaka chimodzi cha chithandizo.

Koma ma Endoleak ambiri a Mtundu wa 2 si owopsa kwenikweni . Amachira okha patatha miyezi isanu ndi umodzi osalandira chithandizo chilichonse. Chifukwa mitsempha yaing'ono yamagaziyo imatseka yokha. Ngakhale ngati sichira, ngati Aneurysm Sac ili yokhazikika ndipo sikukula, dokotala amatha kuyang'anira. Koma nthawi zina, pakapita nthawi, Aneurysm Sac iyi ikhoza kuyambitsa kusintha kwa Aneurysm Sac ndikusintha kukhala Endoleak yoopsa kwambiri monga Aneurysm 1 kapena Aneurysm 3. Ngati zimenezo zitachitika, chithandizo chikufunika. Ngati Aneurysm ndi yayikulu kuposa mamilimita 5 (5mm), mungafunike chithandizo. Ngati Aneurysm sipatsidwa chithandizo, pali mwayi woti Aneurysm iphulika.

Mtundu wachitatu wa Endoleak

Endoleak ya Mtundu 3 imachitika pamene zigawo zolumikizana za stent graft yanu zikulekana, kapena ngati nsalu ya graft yokha ikung'ambika kapena kung'ambika. Izi zikufanana ndi chitoliro chomwe chimagawanika pa cholumikizira, kapena dzenje limapanga chitolirocho. Monga Endoleak ya Mtundu 1, pali chiopsezo cha aneurysm kuphulika chifukwa magazi akuyenda mwachindunji mu thumba la aneurysm pansi pa kupanikizika. Chifukwa chake, chithandizo chachangu n'chofunikira. Komabe, ndi kupita patsogolo kwa kapangidwe ka chipangizocho, Endoleak ya Mtundu 3 ndi yosowa.

Mtundu wachinayi wa Endoleak

Izi zimachitika magazi akatuluka kudzera m'mabowo ang'onoang'ono omwe ali mu stent graft (mabowo a zinthu zomwe zimayikidwa mu graft). Izi nthawi zambiri zimawoneka kumayambiriro kwa chithandizo, koma nthawi zambiri zimatha zokha. Izi ndi zovuta zomwe zimachitika kawirikawiri za graft, ndipo sizimachitika kawirikawiri ndi graft zomwe zimagwiritsidwa ntchito masiku ano.

Mtundu 5 wa Endoleak

Mtundu wa 5 Endoleak umatchedwanso Endotension. Izi ndi zachilendo pang'ono. Chomwe chimachitika pankhaniyi ndichakuti, ngakhale palibe chizindikiro cha Endoleak pa mayeso a Imaging, Aneurysm Sac ikupitirira kukula. Ngakhale kuti chifukwa chenicheni cha izi sichikudziwika bwino, akuganiza kuti pakhoza kukhala pressure transmission kudzera mu Stent Graft, ngakhale kuti palibe kutuluka kwa magazi kooneka. Ichinso ndi vuto lomwe liyenera kuyang'aniridwa.

Kodi zizindikiro za Endoleak ndi ziti?

Vutoli ndi lomwe anthu ambiri ali nalo. Nthawi zambiri palibe zizindikiro zomwe mungayembekezere kuziona ngati muli ndi endoleak. Simungazindikire kusiyana kulikonse. Endoleak imapezeka poyesa kujambula zithunzi zomwe zachitika tsiku lomwe mwalandira chithandizo komanso poyesanso pambuyo pake.Ndicho chifukwa chake ndikofunikira kwambiri kupita kukayezetsa magazi ena. Kupita kukayezetsa magazi pa masiku omwe dokotalayo akuti ndiyo njira yokhayo yodziwira vuto ngati ili mwachangu.

Komabe, ngati aneurysm ikukula ndikuphulika (aneurysm ikuphulika) chifukwa cha endoleak (makamaka mtundu woopsa), ndi vuto lachipatala . Ngati izi zitachitika, zizindikiro zotsatirazi zitha kuchitika. Ngati izi zitachitika , muyenera kuyimba 911 kapena kupita kuchipatala chapafupi nthawi yomweyo :

• Thupi limazizira komanso limatuluka thukuta (Khungu louma, lotuluka thukuta).
• Chizungulire, kumva ngati mutu ukuzungulira.
• Kukomoka, kutaya chidziwitso.
• Kugunda kwa mtima kukukulirakulira ('Kugunda kwa mtima mwachangu').
• Kusanza ndi kusanza.
• Kuvuta kupuma, kumva ngati ukupuma movutikira (kupuma movutikira).
• Kupweteka kwadzidzidzi, koopsa m'mimba, pansi pa msana kapena miyendo.
• Kupweteka kwadzidzidzi komanso kopweteka pachifuwa kapena kumbuyo.

Ngati zizindikirozi zikuwonekera, musazengereze.

Kodi mumapeza bwanji Endoleak?

Monga tanenera kale, endoleak imapezeka kudzera mu mayeso ojambulira. Mayesowa amachitika panthawi yokonza komanso pambuyo pa kukonza kwa aneurysm ya endovascular. Nthawi zambiri, amapezeka tsiku lomwelo kapena mkati mwa masiku 30 kuchokera pamene opaleshoniyo yachitika. Komabe, nthawi zina zimatha kuchitika mpaka miyezi 12 kapena kupitirira apo. Ichi ndichifukwa chake ndikofunikira kwambiri kusunga nthawi zonse zokumana nazo. Monga kukonza galimoto, ichi ndi chinthu chomwe chimayenera kusamalidwa nthawi zonse.

Mayeso oti apeze Endoleak

Mayeso akuluakulu omwe amagwiritsidwa ntchito pozindikira Endoleak panthawi ya chithandizo ndi pambuyo pake ndi awa:

• Computed Tomography (CT) scans: Izi zimatenga zithunzi za mkati mwa thupi. Stent Graft, Aneurysm Sac, ndi kutuluka kwa magazi zimatha kuwoneka bwino.
• Doppler Ultrasound: Izi zimagwiritsa ntchito mafunde a phokoso kuti zione momwe magazi amayendera. Zimatha kuzindikira ngati pali endoleak ndi momwe magazi akuyendera.
• Angiogram: Mu izi, madzi apadera (utoto wosiyana) amalowetsedwa m'mitsempha yamagazi ndipo zithunzi za X-ray zimatengedwa. Kuyenda kwa magazi ndi kutuluka kwa magazi kumatha kuwoneka bwino.

Mayeso awa angathandize kudziwa ngati chithandizo chanu chayenda bwino, ngati stent graft ilipo, komanso ngati pali kutuluka kulikonse kozungulira stent.

Mudzafunika kuchita mayeso a imaging awa kwa miyezi kapena zaka mutatha kulandira chithandizo. Dokotala wanu adzakuuzani za mayesowa komanso kangati komwe muyenera kuwachita. Komabe, mayesowa ndi ofunikira kuti mupeze endoleak iliyonse yomwe ingayambike pambuyo pake (secondary endoleaks) mwachangu ndikuchiza ngati pakufunika kutero.

Kodi mankhwala a Endoleak ndi ati?

Gulu lanu lachipatala lidzachiza Endoleak yanu malinga ndi zosowa zanu. Momwe Endoleak imachitidwira ndi yosiyana kwa munthu aliyense. Izi zimadalira mtundu wa thupi lanu (mwachitsanzo, kutalika kwa khosi lanu la aneurysm, komwe kuli mitsempha yamagazi, ndi zina zotero), mtundu wa Endoleak, ndi komwe ili. Kawirikawiri, pali njira zitatu zazikulu zochizira Endoleak: kuyang'anitsitsa, chithandizo cha endovascular, ndi/kapena opaleshoni yotseguka.

Kuyang'anitsitsa

Ngati muli ndi mtundu wa endoleak wosaopsa kwambiri, monga mtundu wa 2 endoleak, dokotala wanu angakulangizeni kuti mudikire mosamala kuti muwone ngati ungachire wokha. Izi zitha kuchitika ngati mitsempha yamagazi yolumikizanayo yatseka (kutseka), ndikuletsa magazi kupita ku aneurysm sac. Komabe, ngati endoleak ipangitsa kuti aneurysm sac ikule (monga, yokulirapo kuposa 5 mm), muyenera kulandira chithandizo kuti mupewe kuphulika.

Chithandizo cha Endovascular

Uwu ndiye mankhwala ofala kwambiri a aneurysm ya endovascular. Dokotala wanu wa opaleshoni ya endovascular akhoza kukonza aneurysm ya endovascular pogwiritsa ntchito njira zochepa zowononga. Izi zingaphatikizepo:

• Kutsekereza mitsempha yamagazi yomwe imapereka magazi ku aneurysm. Ndiko kuti, chinthu chapadera (chothandizira kupangira embolizing) chimalowetsedwa m'mitsempha yaying'ono yamagazi yomwe imayambitsa Endoleak ya Mtundu wa 2 ndipo imatsekedwa.
• Stent Graft ndi njira yomwe imaphatikizapo kuyika zidutswa zina za Stent (cuffs kapena extenders) kupitirira malo otayikira, kukulitsa dera la mtsempha wanu waukulu (Aorta) komwe Stent inayikidwa. Izi nthawi zambiri zimachitika pa Type 1 Endoleak.
• Kupita mwachindunji ku thumba la aneurysm ndikutseka thumba la aneurysm pogwiritsa ntchito zinthu zonga guluu.

Njira zimenezi zimathandiza kuti chithandizo chichitike popanda kuduladula kwakukulu, kudzera m'bowo laling'ono.

Opaleshoni ('Opaleshoni Yotseguka')

Ngati chithandizo cha endovascular sichingatheke kapena chalephera, opaleshoni yotseguka nthawi zambiri ndiyo njira yomaliza. Izi zimaphatikizapo kuduladula kwakukulu, kulowa mu aneurysm, ndikukonza stent graft kapena kuyika yatsopano. Izi ndizosowa kwambiri, chifukwa njira za endovascular tsopano zapita patsogolo kwambiri.

Kodi mungayembekezere chiyani ngati muli ndi endoleak?

Nthawi zambiri, Endoleak sifunikira chithandizo, makamaka mtundu wachiwiri. Ngakhale chithandizo chikufunika, pali njira zambiri zosafunikira kwambiri zomwe zimafuna kuduladula pang'ono. Mankhwala a Endovascular awa awonetsa kupambana kwakukulu. Kuphatikiza apo, ukadaulo watsopano ukupitilizabe kukonza kugwiritsa ntchito stent grafts zomwe zimachepetsa chiopsezo cha Endoleak.

Ngati muli ndi endoleak, musachite mantha. Dokotala wanu adzakufotokozerani njira zomwe mungatsatire pochiza matenda anu. Chofunika kwambiri ndichakuti mupitirize kuyesedwanso ngakhale endoleak itachira.Ndikofunikira kwambiri kuzindikira ndi kuchiza mavuto aliwonse omwe angakhalepo mtsogolo ndi stent graft yanu mwachangu, monga kusamalira galimoto.

Ndiyenera kupita kwa dokotala liti?

Onetsetsani kuti mwasunga nthawi zonse zokumana ndi dokotala mukatha kulandira chithandizo cha EVAR kapena TEVAR. Dokotala wanu adzakuuzani kangati komwe muyenera kuchita mayeso ojambulira zithunzi. Kawirikawiri, poyamba zimakhala pafupi kwambiri, koma zimatha kuchitika pafupipafupi pakapita nthawi. Tsatirani malangizo amenewo molondola.

Komanso, ngati mukukumana ndi zizindikiro zadzidzidzi zomwe zimabwera ndi kuphulika kwa aneurysm, monga tafotokozera kale, pitani kuchipatala nthawi yomweyo osadikira.

Mafunso oti mufunse dokotala wanu

Mukamaliza opaleshoni yanu ya EVAR kapena TEVAR, funsani dokotala wanu za zoopsa zomwe zingachitike. Komanso, kambiranani za mayeso otsatira ndi mayeso ojambulira omwe mungayembekezere. Mutha kufunsa mafunso monga:

• Kodi zotsatirapo zake zingakhale zotani (zovuta) za mankhwalawa? Kodi chiopsezo changa chokhala ndi endoleak ndi chotani?
• Kodi ndiyenera kubwera kangati kuti ndikalandire chithandizo? Ndi mayeso otani (monga CT scan, ultrasound) omwe ndiyenera kuchita?
• Ndi njira ziti zochiritsira zomwe ndili nazo ngati nditapeza endoleak?
• Ndi kusintha kotani kwa moyo komwe ndingachite kuti mtima wanga ukhale wathanzi komanso kuti stent graft yanga ikhale bwino? (monga kusiya kusuta fodya, kuchita masewera olimbitsa thupi, kudya zakudya zopatsa thanzi)

Ndikofunikira kwambiri kufunsa mafunso ngati awa kuti mumvetse bwino za vuto lanu.

Kodi uthenga wotani umene tingaphunzire kuchokera m'nkhaniyi?

Endoleak ndi vuto lomwe lingatheke pambuyo pokonza aneurysm ya endovascular aneurysm. Simungafunike chithandizo chilichonse. Komabe, ngati mutero, dokotala wanu adzakulankhulani za njira zochiritsira zomwe zili zoyenera kwa inu.

Nthawi zambiri mavuto ngati amenewa amachitika mukatha kuchita opaleshoni yopulumutsa moyo, monga kuchiza aneurysm. Komabe, ubwino wa opaleshoniyi ndi woposa zoopsa zake . Choncho musachite mantha ngati mutadziwa za endoleak.

Chofunika kwambiri ndikupita kukaonana ndi dokotala kuti akakupatseni chithandizo choyenera ndikupeza mayeso omwe akukulimbikitsani. Mwanjira imeneyi, mavuto aliwonse amatha kuzindikirika ndikuchiritsidwa mwachangu.

Ngati mukumva kutopa komanso kutopa, ndi zachilendo. Anthu ambiri akukumana ndi vuto lomweli ngati lanu. Lankhulani ndi dokotala wanu komanso abale anu za njira zothetsera nkhawa zomwe zimabwera chifukwa chochira. Simuli nokha.